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Cosmos Study

No Significant Change in Inflammatory Markers Associated with GLP-1 Medications

October 24, 2024
Dual-Team Study
Team A:Matthew Gracianette, MDJoe Deckert, PhD
Team B:Kersten Bartelt, RNBrendan Joyce

Key Findings

  • Patients prescribed semaglutide or liraglutide showed no significant change in their inflammatory marker levels compared to those not prescribed a GLP-1 medication. 

Inflammation is a common response to infection, injury, or chronic conditions such as diabetes and auto-immune diseases. It can be quantified by testing a patient’s C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) levels.1 Some research suggests that GLP-1 medications may lead to reduced inflammation,2 while other research suggests that weight loss alone may reduce inflammation.3  

We studied 2,983 patients prescribed semaglutide or liraglutide and matched them with 2,983 patients without a GLP-1 medication based on age, diabetes diagnosis, the year of their initial lab, the time between initial and follow-up lab readings, their percentage change in their BMI over the study period, and their Social Vulnerability Index score. Patients were required to have at least two CRP or ESR levels at least 30 days apart to be included. 

While follow-up CRP levels decreased for all groups except non-diabetics prescribed liraglutide, none of those changes were significant, as seen in Figure 1. 

Figure 1
Initial and Follow-up CRP Levels by Treatment
Initial and Follow-up CRP Levels by Treatment
Figure 1. The change in average CRP levels among patients with and without diabetes by treatment.

Next, we evaluated the change in ESR levels. Patients with and without diabetes did not have a significant change in their ESR levels between their initial and follow-up readings, as seen in Figure 2. 

Figure 2
Initial and Follow-up ESR Levels by Treatment
Initial and Follow-up ESR Levels by Treatment
Figure 2. The change in average ESR levels among patients with and without diabetes by therapy.

These findings suggest that these GLP-1 medications do not meaningfully influence inflammation as measured by inflammatory markers after adjusting for weight loss. 

These data come from Cosmos, a dataset created in collaboration with a community of Epic health systems representing more than 274 million patient records from 1,500 hospitals and more than 36,000 clinics from all 50 states, Lebanon, and Saudi Arabia. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson. 

References

  1. Menzel A, Samouda H, Dohet F, Loap S, Ellulu MS, Bohn T. Common and novel markers for measuring inflammation and oxidative stress ex vivo in research and clinical practice—which to use regarding disease outcomes? Antioxidants (Basel). 2021;10(3):414. doi:10.3390/antiox10030414 
  2. Mehdi, S. F., Pusapati, S., Anwar, M. S., Lohana, D., Kumar, P., Nandula, S. A., Nawaz, F. K., Tracey, K., Yang, H., LeRoith, D., Brownstein, M. J., & Roth, J. (2023). Glucagon-like peptide-1: a multi-faceted anti-inflammatory agent. Frontiers in Immunology, 14. https://doi.org/10.3389/fimmu.2023.1148209 
  3. Forsythe LK, Wallace JM, Livingstone MB. Obesity and inflammation: the effects of weight loss. Nutr Res Rev. 2008;21(2):117-133. doi:10.1017/S0954422408138732